Medical care makes you healthier…right?

Do you regularly see your doctor for annual checkups, scans, blood tests, and procedures? While most of us see this as a daily part of a healthy lifestyle, Dr. H. Gilbert Welch would suggest otherwise – in fact, he seems to suggest seeing the doctor more frequently can be harmful to your health. In his book,  OverdiagnosedMaking People Sick in the Pursuit of Health, he argues over the supposed benefits of today’s commonly accepted medical thoughts: early diagnosis is always better and treatment is always better.

What is overdiagnosis? It’s when you are diagnosed by your doctor with a disease and undergo treatment when you either do not show any symptoms or when treatment might actually be harmful. Can this be you? To be sure, Dr. Welch specifies that he is not against doctors or treatment (he is a doctor, after all), but he is against diagnosing diseases when the patient has yet to show signs of disease. He distinguishes that people who have diseases should be treated, but overdiagnosis is when you are not sure the disease will ever exhibit any symptoms (yes, even some cancers will never affect you) and will never cause any trouble. In such cases, treatment is extremely harmful the patient.

While the message of Overdiagnosed is both thought-provoking and informational, the book has some drawbacks. The structure of the book can grow tiresome and repetitive. As each chapter analyzes one or more diseases (there is a chapter on prostate cancer, followed by breast cancer, and osteoporosis…), Dr. Welch provides detailed information on how each is overdiagnosed. For example, what he mostly considers is the worst case scenario for each disease (cancer being death), and he uses graphs and data to show that the increased number of patients with diagnosis have not affected death rates. This means that the increased health care has not actually benefited more people because it is not saving more lives.

While enlightening, the book grows tedious as you think, yes, overdiagnosis, I get it. Nevertheless, the average person who encounters this book may truly believe that early diagnosis and treatment is the best procedure, and this format helps combat these already established mindsets.

Overdiagnosed ties together key parts of what we consider “common sense” in medical procedures today without necessarily thinking of the benefits to the patients. Why? Dr. Welch lays out several possibilities. Some people genuinely believe that early diagnosis is better (and sometimes it is, but often for 1 person out of hundreds who are overdiagnosed). Many doctors, out of fear of being sued, give you a diagnosis because they can be sued for not finding and treating a potential disease, but they can’t be sued for overdiagnosis. Then think about the people who set the arbitrary numbers for certain diseases – if you are above this number you have it, if you are under it, you don’t. These experts are often tied to pharmaceutical companies. And every time they change that arbitrary disease number, millions more are suddenly patients who require costly medicine or surgeries.

You’ve heard it before and you probably believe it – the myth that preemptive discovery and treatment is best. Its most enticing logo is that it can save your life (and for some extremely lucky few, it can). That’s why you undergo daily or yearly scans (MRIs, mammography, cancer) to reassure yourself that you are disease free (at least for now). However, Dr. Welch cites examples of hellish experiences where an avalanche effect happens where one thing leads to another. Many doctors today see something slightly off on your high tech scan and send you off to do more tests and more scans, maybe even a biopsy – all of which can come back with equally ambiguous data.

You see, more technology actually works against our health in some ways because scans show every tiny abnormality in your body – but all of us have abnormalities! Even though you show no symptoms of any disease, doctors order more tests (each test costing money that will support companies, hospitals, and themselves). You might even undergo surgery just because you really (or the doctors really) feel the need for certainty. Out goes your thyroid and then they perform an absolute biopsy. Whoops! It wasn’t cancer, but it was sure good that we checked, right? Not only does the book include a variety of personal stories of hellish experiences, he shares how some diseases are better left untreated until they begin to show symptoms. The most deadly cancers, for example, are fast growing and often manifest between screening times – and they are so quick that no treatment will help. These are the cancers we all dread. Then there are the slow-growing cancers that, Dr. Welch informs us, are slow-growing and may never harm you or be the cause of death (prostate cancer, unless you are a very old man). In such cases, preemptively finding and treating a slow-growing cancer leaves a patient in far worse health than before.

Overdiagnosed is a key book that calls our attention to how we may all be overtreated and undergo unneeded anxiety through commonly accepted testing. If you don’t believe Dr. Welch, check out the New York Time’s column The Agenda: Health where they discuss the repercussions of too much medical care. Moreover, if you follow health news, you might have heard that ovarian cancer screens are not effective. And if the effectiveness of these scans aren’t convincing enough, read the Time’s article on how skewed the rate of examinations are because they expect most patients to have insurance – but charge the same high rates regardless. The fact that hospitals are so evasive about the cost of tests and procedures suggest to me that they have something to hide.

Dr. Welch seems to have picked up on something that is now receiving widespread attention. Although it is shocking to reevaluate ideas such as “Better safe than sorry” regarding testing, Overdiagnosed really drives home the idea of checking your sources as to whether scanning or even treatment is good for you. I would recommend reading several chapters (or all of it), but until you get the main gist since it can be repetitive. Whether or not you agree with Overdiagnosed, the book offers food for thought about how we engage with medical care today.

What is your take on how much we test ourselves?

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8 thoughts on “Medical care makes you healthier…right?

  1. When I first showed a spike in BP out of nowhere and this unexplained hypertension, I noticed the doctors were so quick to just order test after test after test. They also threw enough meds at me to choke a horse. Unfortunately, I took it all, at the time, because they used something I now recognize and steer clear from.

    Scare Tactics.

    They told me all the horrible things that could happen to me with this untreated and unexplained hypertension.

    But then the meds started making me feel even worse. I sat down with my family doctor (who is an ANGEL, if I may say) and told her what the hospital doctors and specialists had said to me. She was horrified. We quickly weaned me off pretty much all the meds and stopped allowing random tests (some that were even repeats- “just to double check”).

    I still have unexplained hypertension that causes issues occasionally. The theory is an autoimmune disease, but I don’t allow further tests. There is no good treatment, even if I’m positive for it. All it involves is careful eating and avoiding of a room full of sick people, which I practice anyway.

    I don’t see any of those specialists anymore. They were very angry when I bluntly told them that their scare tactics were inappropriate, bordering on unprofessional and I would not be making any more appointments with them. Even with that, they still couldn’t drop the scare tactics habit and said that “I could die!!”.

    I hung up. And I feel better for it. It’s been almost a year since that fiasco and I’m still here, still working a normal job, not dead, not bedridden (90% of the time). It’s better than a pile of needless pills any day.

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    • Alice L says:

      Thanks so much for sharing! I, too, have had a terrible experience with America’s medical system. Your summary is so accurate: Scare tactics. “Do this or DIE,” “If you don’t follow our (not advice) orders, you will DIE,” “Your kidneys might fail,” “You could be at risk for cancer – don’t you want to TREAT it?” All that only induces anxiety and stress, which – in the case you really do have an illness – is not helpful.

      I also dislike how aggressive doctors can be. It’s our bodies! We should be able to decide what we put into it, whether or not we agree with the treatment. Doctors label those who do not follow their advice to be “difficult patients.” They act like we’re stupid because they went through medical school. And let’s face it, I have so many friends who are premed or in medical school, and while some of them I think will make fantastic doctors, the others are high achievers who are not empathetic and are becoming doctors for money and acclaim. Some are genuine and really wonderful doctors, but some just aren’t.

      Again, thanks for sharing your story. It’s so pertinent. What if you didn’t have insurance to cover all those tests and prescriptions? The hospital doesn’t care; it just orders tests like a kid in a candy store. And specifically, I loved how you dealt with the possibility that you might have something related to the hypertension. So what? It’s not seriously affecting you and searching for answers might not lead you anywhere better. And now you don’t need to pay for a lot of useless pills – and you don’t have to take them. Doctors act like pills are the cure for everything, but they aren’t. They come with side effects, sometimes as bad as brain leakages or even suicidal tendencies.

      Anyway, thanks for reading and sharing. 🙂

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      • Actually, I didn’t have insurance until this month. So yeah, a lot of needless costs built up fast. I’m still paying some of them off….

        Yeah, the pills were a serious drain on my mental-health actually. A lot of doctors forget to account for that, despite it being on my chart/patient history.

        The biggest arguments my paramedic partner and I get into is about whether doctors are over-medicating (he sometimes thinks they aren’t). But even he had to admit the doctors got ridiculous with my prognosis.

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  2. food4thesoul93 says:

    I think doctors are over doing things at many different levels. I get an annual physical…which goes all year log. He wants to “re-check” this thing or that every 3 months. All of a sudden, were back to the one-year physical time again!

    There’s stuff going on with billing, insurance, cost of “doing business,” whatever! It may only get worse in the future. Anyway, take care and continued success with your posts!

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    • Alice L says:

      Yes, I absolutely agree! All these checkups and tests equal more bills… Medicine and health shouldn’t be a business. Thanks for reading and commenting!

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      • food4thesoul93 says:

        Sadly…it has become all about “business.” And now we will experience some of the least affordable health care options under the “Affordable Care Act!”

        Hold on to your hats, (and health), the worst is coming…

        Take care, and thanks for the visit and comments!
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